Hair Restoration for Women
For women, any degree of hair loss can be devastating. Not only do women often have a difficult time dealing with the psychological effects of hair loss, they are unable to as easily disguise hair loss by wearing baseball hats in social situations. Expensive and uncomfortable options, such as hair extensions and wigs, often end up being the only viable temporary solution. The great expense and time spent applying and maintaining these options more often than not outweigh the benefits they achieve. Dr. Barr and the Hair Restoration Clinic team recognize hair loss in women requires a unique approach. Hair loss in women manifests in a different pattern than men experience, and can be caused by multiple factors.
Causes of Hair Loss
While there are various factors that can cause hair loss in women, the majority of cases are caused by Androgenetic Alopecia. Androgenetic Alopecia is an inherited sensitivity to the effects of androgens on scalp hair follicles. This can begin as early as the late teens to early 20s in women who have experienced premature puberty. Early puberty hair loss can progress to more advanced hair loss if left untreated. Fortunately, women experiencing this type of hair loss do not usually develop as extensive hair loss as occurs in men.
Similar to male pattern baldness, hereditary hair loss in women appears to be related to genetic disposition, hormones and age. The genes that cause hair loss can be inherited from either the mother or father. Hereditary baldness is dependent on hormones called androgens acting on genetically susceptible hair follicles in the scalp, so common hair loss in women is called “Androgenetic Alopecia”.
When not caused by Androgenetic Alopecia, hair loss can be attributed to a wide range of conditions including alopecia areata, hypothyroidism, post pregnancy hormone changes and chemical processing. Hair loss in women can manifest itself as diffuse thinning all over the scalp rather than following a particular pattern as it does in men. Medical evaluation is an important first step in investigating the underlying cause of the problem and determining the optimal course of treatment.
How Hair Loss in Women Differs from Hair Loss in Men
While the variables affecting female hair loss are not completely understood, there are a number of reasons that explain why hair loss in women presents differently than it does in men. Fortunately, testosterone levels in women are much lower than they are in men, making them less likely to develop the extensive hair loss often experienced by men.
The classification system widely used to assess the degree of hereditary hair loss in women is called the Ludwig scale and is shown below. The pattern of hereditary hair loss in women is much different from that seen in men.
The Role of DHT
When testosterone is chemically altered by the enzyme 5-alpha reductase in the skin, it becomes a more potent hormone, known as dihydro-testosterone (or DHT). Fortunately, compared to men, women have only 50% of this enzyme and have even less in the crown. DHT acts by binding to special receptor sites on the cells of the hair follicles. The effect is not immediate, however, and susceptible hair follicles must continually be exposed to DHT over a period of time for hair loss to occur.
Women also have higher levels of an enzyme called aromatase in all areas of the scalp that is thought to potentially block the formation of DHT. This enzyme is present in high concentration in the frontal hairline in women, which may be the reason for this area being resistant to balding.
‘Miniaturization’ of Hair Follicles
Once the effect of DHT begins to manifest itself, the length of the anagen (growing) cycle of the hair shaft decreases and the telogen (resting) phase of the hair shaft lengthens. Genetically susceptible hair follicles that were producing healthy, terminal hairs will begin to produce thinner, shorter, more brittle hairs with weaker shafts (“miniaturization”). As the condition persists, the follicles produce finer hairs, until they become almost invisible, short, vellus hairs, or die out altogether. Thinning scalp hair in women due to Androgenetic Alopecia does not uniformly grow smaller in diameter (miniaturize) as it does in men. Women with this type of hair loss usually have miniaturizing hairs of variable diameter over all affected areas of the scalp.
Miniaturization of hairs may occur for other reasons in women so the presence of miniaturization alone cannot be used to diagnose Androgenetic Alopecia. In some cases, post-menopausal women will experience miniaturization and note that their hair has become difficult to style.
Accelerated hair loss does not occur at a consistent rate or all at once, but rather in cycles. People who are losing their hair experience alternating periods of slow and rapid hair loss as well as periods of relative stability. In women, there is often a period of accelerated loss during times of hormonal change, such as pregnancy and menopause. Many of the factors that cause the rate of hair loss to accelerate or decelerate are unknown.
Am I a Candidate for Female Hair Restoration?
You may be an ideal candidate for female hair restoration if:
- You are suffering from Androgenetic Alopecia.
- You are experiencing hair loss due to trauma (including burns or incisions from surgical procedures).
- You wish to change your hairline.
- You wish to have fuller eyebrows (Read more on Eyebrow Restoration at Hair Restoration Clinic).
- You are experiencing traction or marginal alopecia.